Full Legal Name
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Country
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State
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City
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Mailing Address
Phone Number
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Email Address
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Referral Source
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LinkedIn
Indeed
Other Job Searching Platform
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Current Employee Referral (Insert Name Below)
Other (Please Specify)
If you selected "Employee Referral" or "Other" Above, Please specify.
Birth Date (mm/dd/yyyy)
Highest Level of Education
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Highschool Diploma or equivalent
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Are you legally authorized to work in the United States?
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Will you now, or in the future, require sponsorship for employment visa status (e.g. H-1B Visa Status)?
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Yes
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Do you have reliable transportation?
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Yes
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If extended a job offer, are you willing to submit to a detailed background check which could include the following (education verification, drug screening, employment verification, etc.)?
Yes
No
Have you ever been employed and/or applied for a position at this company?
Yes
No
Do you have any family members who are currently employed/ have been employed by ICT?
Yes
No
Have you ever been discharged or forced to resign from any previous place of employment?
Yes
No
Voluntary Self Identification of Gender and Ethnicity To comply with laws regarding equal employment opportunity and affirmative action, our company tracks ethnicity and gender. We need your help with this process. The completion of this section is voluntary and refusal to do so will not affect the processing of your application. This information is kept separate from your application and not viewed by any hiring manager. Please acknowledge that you understand the following questions are OPTIONAL
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Yes, I understand the following questions are optional to complete
Gender
Male
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Ethnicity
Hispanic or Latino
Not Hispanic or Latino
I do not wish to self-identify
Do you identify as one or more of the classifications of protected veterans listed: 1. This employer is a Government contractor subject to the Vietnam Era Veterans' Readjustment Assistance Act of 1974, as amended by the Jobs for Veterans Act of 2002, 38 U.S.C. 4212 (VEVRAA), which requires Government contractors to take affirmative action to employ and advance in employment: (1) disabled veterans; (2) recently separated veterans; (3) active duty wartime or campaign badge veterans; and (4) Armed Forces service medal veterans. These classifications are defined as follows: A disabled veteran is one of the following: a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or a person who was discharged or released from active duty because of a service-connected disability. A recently separated veteran means any veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval, or air service. An active duty wartime or campaign badge veteran means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense. An Armed forces service medal veteran means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985. Protected veterans may have additional rights under USERRA- the Uniformed Services Employment and Reemployment Rights Act. In particular, if you were absent employment in order to perform service in the uniformed service, you may be entitled to be reemployed by your employer in the position you would have obtained with reasonable certainty if not for the absence due to service. For more information, call the U.S. Department of Labor's Veterans Employment and Training Service (VETS), toll-free, at 1-866-4-USA-DOL. 2. If you believe you belong to any of the categories of protected veterans listed above, please indicate by checking the appropriate box below. As a Government contractor subject to VEVRAA, we request this information in order to measure the effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA. 3. Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. The information provided will be used only in ways that are not inconsistent with the Vietnam Era Veterans' Readjustment Assistance Act of 1974, as amended. 4. The information you submit will be kept confidential, except that (i) supervisors and managers may be informed regarding restrictions on the work or duties of disabled veterans, and regarding necessary accommodations; (ii) first aid and safety personnel may be informed, when and to the extent appropriate, if you have a condition that might require emergency treatment; and (iii) Government officials engaged in enforcing laws administered by the Office of Federal Contract Compliance Programs, or enforcing the Americans with Disabilities Act, may be informed.
Yes
No
I do not wish to self-identify
Why are you being asked to complete this form? We are a federal contractor or subcontractor. The law requires us to provide equal employment opportunity to qualified people with disabilities. We have a goal of having at least 7% of our workers as people with disabilities. The law says we must measure our progress towards this goal. To do this, we must ask applicants and employees if they have a disability or have ever had one. People can become disabled, so we need to ask this question at least every five years. Completing this form is voluntary, and we hope that you will choose to do so. Your answer is confidential. No one who makes hiring decisions will see it. Your decision to complete the form and your answer will not harm you in any way. If you want to learn more about the law or this form, visit the U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp.i How do I know if I have a disability? A disability is a condition that substantially limits one or more of your “major life activities.” If you have or have ever had such a condition, you are a person with a disability. Disabilities include, but are not limited to: Alcohol or other substance use disorder (not currently using drugs illegally)Autoimmune disorder, for example, lupus, fibromyalgia, rheumatoid arthritis, HIV/AIDSBlind or low visionCancer (past or present)Cardiovascular or heart diseaseCeliac diseaseCerebral palsyDeaf or serious difficulty hearingDiabetesDisfigurement, for example, disfigurement caused by burns, wounds, accidents, or congenital disordersEpilepsy or other seizure disorderGastrointestinal disorders, for example, Crohn's Disease, irritable bowel syndromeIntellectual or developmental disabilityMental health conditions, for example, depression, bipolar disorder, anxiety disorder, schizophrenia, PTSDMissing limbs or partially missing limbsMobility impairment, benefiting from the use of a wheelchair, scooter, walker, leg brace(s) and/or other supportsNervous system condition, for example, migraine headaches, Parkinson's disease, multiple sclerosis (MS)Neurodivergence, for example, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder, dyslexia, dyspraxia, other learning disabilitiesPartial or complete paralysis (any cause)Pulmonary or respiratory conditions, for example, tuberculosis, asthma, emphysemaShort stature (dwarfism)Traumatic brain injury
Yes, I have a disability, or have had one in the past
No, I do not have a disability and have not had one in the past
I do not want to answer
Yes, I.C. Thomasson can contact me about job opportunities.
I may receive phone/text communications about career opportunities, interviews, job offers, and other related information from I.C. Thomasson (+1 (615) 813-2786) (Message and data rates may apply, message frequency varies). I may receive emails from icthomasson.com. I can opt-out at any time by unsubscribing or texting STOP. My data will be handled in accordance with
the privacy policy
. Terms of service:
https://loxo.co/legal/master-subscription-terms-of-service-agreement
. For help, email
support@loxo.co
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